This is what happens here, too.  Students and Residents have  codes and
direct access to the Medical School Library, with a rather rich
resources.  However, only Medical Staff who are officially "teaching
faculty" get such access.  SO we have a rather large population of
"others", and for those we provide Hospital networked databases and full
text journals online to the limit of our budget.  That does not say
much, exp. when prices go up and budgets do not (or shrink).  The
Medical School Library, however, does not maintain a Nursing collection,
and ours is a much better one.  The Librarians have free access to the
Medical School Library, and we act as the supplier.  Instead of going
online to Docline, we access the Medical School and print what is needed
and available. Since no one library has "everything", Docline fills the
gap for the remaining materials, which is still considerable.  Not as
much as it used to be, but still respectable.  I have not faced serious
cutbacks, and hope this situation "holds" for the near future. 

 So I guess the responsibility to fill this information gap is simply
that of the Hospital Library. It is nothing new - it has always been
that way, the "haves" had their own libraries and the "have not" used
the public library if and when it was available.  The hard task is
convincing the "powers" of the consequences of this gap and of the need.
And the need should be real, even if it is in forms of "testimonials"
from users.  The Librarian needs to make sure that the underserved are
aware of the library services, and use the library.  The reality has to
penetrate into the minds of all those "others" that if you don't see it,
it is nevertheless available.  Maybe all of us need to adopt the "please
bother us" and "we will get you anything (almost)" stance.  I have had
physicians, nurses and others apologize by saying "oh, but I did not
want to bother you..."  My response is always "Please bother us - we are
here to BE bothered".

If you were looking for simple answers, there aren't any.

Dalia Kleinmuntz
Webster Library, Evanston hospital/ENH

-----Original Message-----
From: Susan Klimley [mailto:[log in to unmask]] 
Sent: Tuesday, November 23, 2004 9:40 AM
To: [log in to unmask]
Subject: CHAT: affiliate hospitals

An issue related to Rebecca Zakoor posting: user fees for electronic
resources in teaching hospital library 11/18/04

The issue of access to electronic resources is an interesting aspect of
the hospital / academic center affiliation.  Pre-digital world, the
hospital library provided onsite access to paper materials for both the
staff affiliated with the academic center (often doctors, residents,
medical students) and the hospital staff (often nurses, pharmacists,
physical therapists, dieticians and other allied health and
administrators).  In the digital world, affiliates often have immediate
access to all the academic centers resources. They have far more
resources than could have been offered in the hospital library. This may
be one of the reasons we are seeing hospital library down-sizing or
elimination.  Meanwhile hospital employees, (nurses and other allied
health employees) may be blocked from access to the academic center
library since they are not academic center employees. Their access to
paper resources and now electronic resources may be far less creating
two-tiered access to inf
ormation.  An unintended consequence of digital access?  I would be
interested whether others have seen this happen and discussion.

Susan Klimley
Director, Health Sciences Library
Elmhurst Hospital Center, Elmhurst NY
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